WO2002040089A2 - Marqueurs de direction d'energie - Google Patents

Marqueurs de direction d'energie Download PDF

Info

Publication number
WO2002040089A2
WO2002040089A2 PCT/US2001/045525 US0145525W WO0240089A2 WO 2002040089 A2 WO2002040089 A2 WO 2002040089A2 US 0145525 W US0145525 W US 0145525W WO 0240089 A2 WO0240089 A2 WO 0240089A2
Authority
WO
WIPO (PCT)
Prior art keywords
energy
catheter system
distal end
rotatable tube
emission
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/US2001/045525
Other languages
English (en)
Other versions
WO2002040089A3 (fr
Inventor
Jon Mcintyre
Norman Farr
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Cardiofocus Inc
Original Assignee
Cardiofocus Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Cardiofocus Inc filed Critical Cardiofocus Inc
Priority to AU2002220078A priority Critical patent/AU2002220078A1/en
Publication of WO2002040089A2 publication Critical patent/WO2002040089A2/fr
Publication of WO2002040089A3 publication Critical patent/WO2002040089A3/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B90/00—Instruments, implements or accessories specially adapted for surgery or diagnosis and not covered by any of the groups A61B1/00 - A61B50/00, e.g. for luxation treatment or for protecting wound edges
    • A61B90/39—Markers, e.g. radio-opaque or breast lesions markers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/04—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating
    • A61B18/12—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by heating by passing a current through the tissue to be heated, e.g. high-frequency current
    • A61B18/14—Probes or electrodes therefor
    • A61B18/1492—Probes or electrodes therefor having a flexible, catheter-like structure, e.g. for heart ablation
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B2018/00315—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body for treatment of particular body parts
    • A61B2018/00345—Vascular system
    • A61B2018/00404—Blood vessels other than those in or around the heart
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B18/00—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body
    • A61B18/18—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves
    • A61B18/1815—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves
    • A61B2018/1861—Surgical instruments, devices or methods for transferring non-mechanical forms of energy to or from the body by applying electromagnetic radiation, e.g. microwaves using microwaves with an instrument inserted into a body lumen or cavity, e.g. a catheter

Definitions

  • an ablation procedure for cardiac arrhythmias there are various medical procedures where energy is directed toward subject tissue under fluoroscopic guidance.
  • an energy emitting device is drawn through a vessel under fluoroscopic guidance.
  • photonic diffusing tip catheters with gold reflectors on one side are used to preferentially direct energy to subject tissue.
  • An example of such a device can be seen in U.S. Patent 5,908,415 at Fig. 5.
  • reflector 62 causes energy to be directed in a certain direction, h order to determine in which direction the energy is directed, the operator must first observe the device under fluoroscopy, then rotate the device and lastly, view it under fluoroscopy a second time. The direction of energy emission is then determined from how the fluoroscopic view of the device changed from the first observation to the second. The operator observes how the gold reflector has moved from the first view to the second, thus revealing the direction of energy emission.
  • the present invention addresses the foregoing need of the prior art.
  • the present invention provides energy direction markers which quickly and accurately indicate the direction in which energy will be emitted when initially viewed under fluoroscopy while minimizing the need for operator judgment.
  • the invention catheter system includes: an elongated rotatable tube being rotatable about a longitudinal axis and having a distal end and a proximal end; an energy emitter located at the distal end of the elongated rotatable tube; and at least one energy direction marker at the distal end of the elongated rotatable tube, which is visible under fluoroscopy and indicates the direction of energy emission from the energy emitter, such that the direction of energy emission can be varied and is indicated as a function of rotation of the elongated rotatable tube about a longitudinal axis.
  • the energy direction marker may be a band that is fully circumferential around the distal end of the elongated tube and is located adjacent to an energy emitter.
  • the energy direction marker may be made from gold, platinum, tantalum or radiopaque ink.
  • the catheter system may emit ultrasound energy, cryothermal energy, radiofrequency energy or microwave energy.
  • the energy emitter can be a light diffuser and may include an energy reflecting element.
  • the energy direction marker may be integrated into the energy reflecting element and may be a protrusion from the energy reflecting element or a void in the energy reflecting element which is the result of a cut-away.
  • the protrusion or void is of a shape or geometry which when viewed under fluoroscopy indicates orientation of the energy emitter and hence direction of energy emission.
  • the energy direction marker may be separate from the energy reflecting element.
  • the energy reflecting element may be made from gold.
  • FIG. 1 is a schematic diagram of a catheter system of the present invention as used in a vein, an artery or any other anatomical duct.
  • Fig. 2A is a diffuser tip with an energy reflector and a solid circumferential band serving as an energy direction marker of the present invention.
  • Fig. 2B is a cross-sectional view of the diffuser tip of Fig. 2A when viewed under fluoroscopy.
  • Fig. 3 is a diffuser tip with triangular energy direction markers that are integrated into the energy reflector.
  • Fig. 3 A is a view of the diffusing material when laid flat and having energy direction markers on both longitudinal sides.
  • Fig. 4 is a diffuser tip with semi-circular energy direction markers created by cutaways in the energy reflector.
  • Fig. 5 is a diffuser tip with triangular energy direction markers created by cutaways in the energy reflector.
  • Fig. 6 is diffuser tip with triangular energy direction markers created by protrusions from the energy reflector.
  • Fig. 7 and 7 A are schematic views of the light diffusing tip employed in the preferred embodiment.
  • a fluoroscopic view that is in a plane perpendicular to the desired energy direction presents the best view of the Energy Direction Markers.
  • the only material that can be seen is the radiopaque material, usually gold, out of which the energy reflector or solid circumferential band serving as an energy direction marker is made.
  • FIG. 1 Illustrated in Figure 1 is a catheter system embodying the present invention.
  • the catheter system 1 is formed of an elongated body 2 rotatable about a longitudinal axis, an energy reflector 4 at the distal end 3 of the elongated rotatable tube 2 and at least one energy direction marker 5 at the distal end 3 of the elongated rotatable tube 2.
  • the energy reflecting element (energy reflector) 4 is a diffusing tip 60 such as that described in U.S. Patent No. 5,908,415 and illustrated herein in Figures 7 and 7 A.
  • the illustrated light diffusing tip 60 utilizes a reflector 62 placed on one side of the diffusing tip (about 180 degrees radially or extending around about half the circumference, throughout the length of the energy emitter 63, or other circumferential reflector angles may be used).
  • the reflector 62 is preferably formed of gold foil or other material of high reflectance and relatively low hardness such that it is easily formed into shape.
  • the reflector 62 blocks and reflects light back towards the scattering media (energy emitter) 63 of the light diffusing tip 60.
  • the energy emitting element 63 with such a reflector 62 causes more energy to be directed toward the tissue of interest.
  • the direction of energy emission is indicated by arrows radially throughout about 180° in Fig. 7A.
  • Figure 2A shows a diffusing tip 3 that uses a solid circumferential band 5 to indicate the direction of energy.
  • This solid circumferential band 5 has a diameter very similar to that of the entire diffusing tip 3.
  • the energy reflector 4 is of semi-cylindrical shape like reflector 62 of Fig. 7 and 7 A and is located adjacent to the solid circumferential band 5.
  • Figure 2B is a profile view of the diffusing tip of Figure 2 A when viewed under fluoroscopy. The circumferential band appears as a line the length of its diameter.
  • the energy reflector 4 appears as a long rectangle in the axial direction and indicates the length of the diffusing tip, its width depending on the current rotation of the diffusing tip 3 and varying from half of the diameter of the solid circumferential band 5 when the energy direction is either straight up or down, to nearly the full diameter of the solid circumferential band 5 when the energy direction is either straight into or out of the page. If the energy reflector 4 appears to be aligned with the lower portion of the solid circumferential band 5, then the direction of energy emission is upward. Likewise, if the energy reflector 4 appears to be aligned with the upper portion of the solid circumferential band 5, then the direction of energy emission is downward.
  • FIG. 3 shows one such embodiment where the energy reflector 25 is extended longitudinally from both ends of the reflector 25 beyond the area 21 in which energy is emitted.
  • the extended portions 22 of the energy reflector 25 are shaped to indicate the direction in which energy is emitted.
  • the shape demonstrated in Figure 3 consists of (i) a triangular cutout 23 pointing down from the edge of the elongated portion of the reflector in series with (ii) half of another triangular cutout 24 pointing down, thus leaving a triangular shaped portion of the elongated portion of the energy reflector 26 pointing up (away from the reflector edge) and indicating the direction of energy emission.
  • the shape of these extended portions of the reflector ends 22 serve as energy direction markers which instantly reveal the direction of energy emission.
  • the energy reflector 25 can be extended on one longitudinal side only so that it's fluoroscopic image will not be blocked by any part of the reflector 25 on the other side, or it can be extended on both longitudinal sides, in which case the energy direction markers will be visible when the diffusing tip 60 is rotated such that the energy direction markers are in alignment when viewed from the side.
  • Figure 3 A shows the shape of the diffusing material when laid flat and where there are energy direction markers on both longitudinal sides.
  • Figures 4 and 5 show other variations of energy direction markers that consists of portions of the energy reflector 31 and 41 that are cut away and show as voids 32 and 42 in the energy reflector's profile when viewed under fluoroscopy.
  • voids 32 and 42 are made by cutting away a portion of the energy reflector 31 and 41 from the area that would appear as the bottom of the reflector when viewed in an orientation where energy emission is upward.
  • the shape cut away is that of a semi-circle and in Figure 5 the shape cut away is a triangle. The arch or point, respectively, of these cut-away shapes thus provides a visual indication under fluoroscopy of the direction in which the reflector is oriented and hence the direction in which energy is emitted.
  • Figure 6 shows an alternative to cut-aways in the energy reflector.
  • Fig. 6 shows pointed protrusions 52 from the edge of the energy reflector 51 that serve as direction indicators. Triangular shapes are shown in Figure 6, but many shapes will sufficiently indicate energy direction.
  • the energy direction markers of Figures 3 through 6 need not be integrated with the energy reflector.
  • the energy direction markers can be separate elements from the energy reflector.
  • the energy direction markers can be located elsewhere in the elongated rotatable tube provided they are still visible under fluoroscopy at the same time as the energy reflector.
  • the energy direction markers need not protrude or be cut away from the upper or lower profile edge of the energy reflector, but may also extend or be cut away from the sides of the energy reflector.
  • the energy direction marker need not be any specific geometric shape that "points" to the direction of energy emission, rather it can be an entirely separate piece of radiopaque material that is in such proximity to the energy reflecting element such that when viewed under fluoroscopy, the relationship of the piece of radiopaque material to the energy reflecting element renders the direction of energy emission obvious upon initial view.

Landscapes

  • Health & Medical Sciences (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Molecular Biology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Medical Informatics (AREA)
  • Pathology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Media Introduction/Drainage Providing Device (AREA)
  • Endoscopes (AREA)

Abstract

L'invention concerne un système de cathéter (1) comportant une tige allongée (2), un réflecteur d'énergie (4) et un marqueur de direction d'énergie (5). Ce marqueur de direction d'énergie (5) est visible en fluoroscopie et il indique la direction d'émission d'énergie, lors d'une observation initiale par l'opérateur du système de cathéter (1).
PCT/US2001/045525 2000-11-20 2001-11-15 Marqueurs de direction d'energie Ceased WO2002040089A2 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU2002220078A AU2002220078A1 (en) 2000-11-20 2001-11-15 Catheter system having energy direction markers

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US71673800A 2000-11-20 2000-11-20
US09/716,738 2000-11-20

Publications (2)

Publication Number Publication Date
WO2002040089A2 true WO2002040089A2 (fr) 2002-05-23
WO2002040089A3 WO2002040089A3 (fr) 2002-10-17

Family

ID=24879237

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US2001/045525 Ceased WO2002040089A2 (fr) 2000-11-20 2001-11-15 Marqueurs de direction d'energie

Country Status (2)

Country Link
AU (1) AU2002220078A1 (fr)
WO (1) WO2002040089A2 (fr)

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9333031B2 (en) 2013-04-08 2016-05-10 Apama Medical, Inc. Visualization inside an expandable medical device
US9610006B2 (en) 2008-11-11 2017-04-04 Shifamed Holdings, Llc Minimally invasive visualization systems
US9655677B2 (en) 2010-05-12 2017-05-23 Shifamed Holdings, Llc Ablation catheters including a balloon and electrodes
US9795442B2 (en) 2008-11-11 2017-10-24 Shifamed Holdings, Llc Ablation catheters
US10098694B2 (en) 2013-04-08 2018-10-16 Apama Medical, Inc. Tissue ablation and monitoring thereof
US10349824B2 (en) 2013-04-08 2019-07-16 Apama Medical, Inc. Tissue mapping and visualization systems
US10736693B2 (en) 2015-11-16 2020-08-11 Apama Medical, Inc. Energy delivery devices

Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5908415A (en) 1994-09-09 1999-06-01 Rare Earth Medical, Inc. Phototherapy methods and apparatus

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5203777A (en) * 1992-03-19 1993-04-20 Lee Peter Y Radiopaque marker system for a tubular device
US5485840A (en) * 1994-03-15 1996-01-23 Bauman; Robert P. Method of precise guidance for directional atherectomy using ultrasound
US6146409A (en) * 1996-05-20 2000-11-14 Bergein F. Overholt Therapeutic methods and devices for irradiating columnar environments
US5921978A (en) * 1997-06-20 1999-07-13 Ep Technologies, Inc. Catheter tip steering plane marker

Patent Citations (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5908415A (en) 1994-09-09 1999-06-01 Rare Earth Medical, Inc. Phototherapy methods and apparatus

Cited By (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9610006B2 (en) 2008-11-11 2017-04-04 Shifamed Holdings, Llc Minimally invasive visualization systems
US9717557B2 (en) 2008-11-11 2017-08-01 Apama Medical, Inc. Cardiac ablation catheters and methods of use thereof
US9795442B2 (en) 2008-11-11 2017-10-24 Shifamed Holdings, Llc Ablation catheters
US10251700B2 (en) 2008-11-11 2019-04-09 Shifamed Holdings, Llc Ablation catheters
US11744639B2 (en) 2008-11-11 2023-09-05 Shifamed Holdings Llc Ablation catheters
US9655677B2 (en) 2010-05-12 2017-05-23 Shifamed Holdings, Llc Ablation catheters including a balloon and electrodes
US9333031B2 (en) 2013-04-08 2016-05-10 Apama Medical, Inc. Visualization inside an expandable medical device
US10098694B2 (en) 2013-04-08 2018-10-16 Apama Medical, Inc. Tissue ablation and monitoring thereof
US10349824B2 (en) 2013-04-08 2019-07-16 Apama Medical, Inc. Tissue mapping and visualization systems
US11439298B2 (en) 2013-04-08 2022-09-13 Boston Scientific Scimed, Inc. Surface mapping and visualizing ablation system
US11684415B2 (en) 2013-04-08 2023-06-27 Boston Scientific Scimed, Inc. Tissue ablation and monitoring thereof
US10736693B2 (en) 2015-11-16 2020-08-11 Apama Medical, Inc. Energy delivery devices

Also Published As

Publication number Publication date
AU2002220078A1 (en) 2002-05-27
WO2002040089A3 (fr) 2002-10-17

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